TITLE:
Analysis on Emergency Microsurgical Treatment for Cerebral Hernia Caused by Intracranial Anterior Circulation Aneurysm with Intracranial Hematoma
AUTHORS:
Gang Yang, Junjie Lv, Shaojun Yang, Chao Gu, Chenbing Wang, Lulu Weng, Feng Ding
KEYWORDS:
Anterior Circulation Aneurysm, Intracranial Hematoma, Cerebral Hernia, Microsurgery
JOURNAL NAME:
Open Journal of Emergency Medicine,
Vol.9 No.3,
July
5,
2021
ABSTRACT: Objective: This study is to discuss CT performances and direct surgical strategy as
well as therapeutic effect of patients who have rupture hemorrhage of
intracranial anterior circulation aneurysm with complications of intracranial
hematoma and cerebral hernia. Methods: CT performances and treatment of 14
patients who have rupture hemorrhage of intracranial anterior circulation
aneurysm with complications of intracranial hematoma and cerebral hernia in our
hospital from March, 2019 to March, 2021 were reviewed. The relationship between
hematoma caused by intracranial anterior circulation aneurysm and position of the
aneurysm was analyzed. Besides, surgical processing
keys were discussed. Results: For all selected patients,
intracranial hemorrhage is proved to be caused by rupture of aneurysm. Among them,
there are 2 cases of anterior communicating aneurysms, 3 cases of posterior communicating
aneurysms, and 9 cases of middle cerebral aneurysms. According to exploration, we found 1 case of multiple aneurysm, which
is the combination of a middle cerebral aneurysm (the responsible aneurysm) and
ipsilateral posterior communicating aneurysm. There were two cases of intraoperative
rupture. In this study, 3 patients died. According to GOS grading at 3 months after
the operation, there were 1 case of V-grade (good recovery), 3 cases of IV-grade
(self-maintenance), 5 cases of III-grade (severe disabled), 2 cases of II-grade
(persistent vegetative state) and 3 cases of I-grade (died). Conclusions:
Emergency microsurgical treatment can lower the
death rate of cerebral hernia caused by intracranial anterior circulation
aneurysm with intracranial hematoma and recover the neurological functions to the
maximum extent.